It’s easy to see how the hospital can be an intimidating place for a patient. Being alone, in an unknown environment, covered only a flimsy cloth gown, and surrounded by strangers can make anyone anxious. Now, imagine not knowing what these strangers are saying to you, about you. Imagine these strangers cannot understand a single word you say.
I had just finished up a previous case in the OR with the orthopedics team when the fellow asked me to go check on the next patient. He should be in the regional block room. So I went to find him. It was nice to have a role on the team, even if it was limited to assessing and calling down patients.
The regional block room is a large, open room at the end of one of the surgical corridors. I found him behind drawn curtains. The whiteboard at the end of the hallway stated his name, Chen (name has been changed for confidentiality), and his ailment: a distal radius fracture. He was there to receive a regional block because his age and medical conditions made him a poor general anesthetic candidate.
Two nurses and the anesthesia team assembled at the foot of the bed. Despite the company, he was alone. The talk circled around him, but I sensed he wasn’t following the conversation. He looked dazed and confused. The bed seemed to swallow him.
One of the best things about being in the medical field is that you remain a learner for the rest of your career. Moreover, you never know when a lesson might pop up. At most, you can hope to be ready to appreciate the lesson when it presents itself.
Looking at Chen, I realized that because he did not understand what was being said, nor was he able to ask questions, he wasn’t getting the best available care. In the first weeks of clerkship I felt lost because I didn’t know how to contribute without a medical degree. Over the months that passed, I subtly picked up on small ways to help. It wasn’t until seeing Chen, realizing he spoke Mandarin, and getting the epiphany that I spoke the same language as well, that it all clicked: the only one that was holding me back from taking the initiative was myself. I pushed towards the front of the group and, speaking in Mandarin, explained that while I was not the interpreter, I was here to help him ask and answer questions for the the team.
Chen smiled, and I’m sure I saw relief wash over the faces of both the nurses and the anesthesia resident. I typically don’t like to think of myself being smug over what I’ve done since starting medical school, but I can safely say that this was something I was proud of doing.
At the same time it was a big crystallizing moment of insight.For me, a large part of the clerkship has been the slow process of learning to be comfortable with being uncomfortable, stepping out the niche of security, and battling through a great deal of self-doubt. These have been areas with which I’ve always struggled but never explicitly acknowledged. This year, due to the high pressure crucible of learning on the wards, I was forced to confront them.
At the end of the case, I went to visit Chen again. He was resting in recovery, rousable but still under the influence of the anesthetic. As I approached, he recognized me, sat up a bit, and we chatted again. I stayed until my fellow found me and signaled for me to rejoin the team. He again repeated his thanks for my help.
In reality, we both helped each other that afternoon.
The clerkship experience can be the definition of tumultuous. As we’re suddenly tossed into the wards, it’s easy to become caught up in the shuffle as we move through our service rotation. These posts try to take a step back and become “a fly on the wall” observing and reflecting on the overall movement through clerkships.